Enabling the NHS estate transformation

26 January 2018

The integration of care across acute, community, primary and social care for the benefit of patients is the future for the NHS, set out in the Five Year Forward View.

Making this ‘game changing’ transformation a reality, however, is a substantial challenge. Delivering the right care in the right place requires the right infrastructure that is affordable and sustainable. Therefore, as care models transform, so too must the NHS estate.

Since 2000, Community Health Partnerships (CHP) has been working closely with the NHS to improve access to primary and community care through public private partnerships. To date our NHS Local Improvement Finance Trust (LIFT) programme has leveraged £2.5 billion new investment and delivered 340 fully integrated and well-maintained facilities focused on improving the health of the community.

We recognised then that buildings needed to be more than just health facilities, but community hubs. This meant integrating services such as primary care with local authorities in purpose built health, fitness and wellbeing centres. Many LIFT buildings are mixed use developments combining health and community with housing for extra care or key work accommodation. For example, Orford Jubilee Park Health Centre, Warrington is a LIFT funded project housing three GP practices, mental health and community services, sports facilities, outdoor pitches, swimming pool and library. While Parkview Centre for Health and Wellbeing in London is a health and wellbeing centre, that also provides 170 homes.

This holistic approach to integrated care facilitated by our buildings leads to greater staff and patient satisfaction.

The Naylor Review highlighted the big issues of poor utilisation and back-log maintenance in the NHS estate. As identified in Reform’s research, more can be done to get the most out of existing estate. CHP is playing its part. Our buildings are modern premises with no back-log maintenance costs. Utilisation is a key priority and work is ongoing to review the financial arrangements, encourage the use of shared space, utilise technology and open up the building to wider community use. These are some of the ways we are making the estate work better for the NHS and its patients.

As care models change, buildings must flex in response. We have shown that we can vary the use of our buildings to accommodate changes to service delivery required by the NHS. For example, we have converted office space into clinical use to accommodate outpatient services and reconfigured one of our buildings to include a renal unit. These have significantly improved access to patient services.

Driving efficiency across the NHS, as highlighted by the Carter Review, applies to estates also. Our innovation work is looking at ways to improve energy consumption and sustainability, while creating healthier environments, by exploring building design concepts such as Passivhaus – a first in the NHS. Our initial findings show there is significant potential to reduce a building’s running cost compared to a traditional build.

There has been publicity on the limited availability of public capital for developing health infrastructure, particularly to support care outside of hospital.  Reform’s latest research presents a helpful diagnosis, identifying the opportunities to achieve much needed investment particularly in the primary care estate. Public private partnership is one of the options that remains relevant and available.

Dr Sue O’Connell, Chief Executive Officer, Community Health Partnerships

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